Original research| Volume 97, ISSUE 4, P545-551, April 2016

Effect of Leg Selection on the Berg Balance Scale Scores of Hemiparetic Stroke Survivors: A Cross-Sectional Study

Published:December 18, 2015DOI:



      To examine whether selection of the nonparetic or paretic leg as the weight-bearing leg in item 13 (standing unsupported one foot in front) and item 14 (standing on one leg) of the Berg Balance Scale (BBS) influences the item scores, and thus the total score.


      Cross-sectional study.


      University-based rehabilitation laboratory.


      Community-dwelling people (N=63, aged ≥50y) with chronic stroke.


      Not applicable.

      Main Outcome Measure



      The 4 BBS total scores ranged from 48.4 to 50.7. The total score was significantly lower when a participant was asked to step forward with the nonparetic leg in item 13, and stand on the paretic leg in item 14. Fewer participants received a maximum score with the BBS1 formulation than the others. In addition, the correlations with walking speed and Activities-specific Balance Confidence Scale scores were greatest with the BBS1 score.


      Our findings suggest that BBS1 was the most challenging formulation for our participants; this might serve to minimize the ceiling effect of the BBS. These findings provide a rationale for amending the BBS administration guidelines with the BBS1 formulation.


      List of abbreviations:

      ABC (Activities-specific Balance Confidence Scale), AUC (area under the curve), BBS (Berg Balance Scale), FMA-LE (Fugl-Meyer Assessment–Lower Extremity), FTSTS (5 times sit-to-stand test), ICC (intraclass correlation coefficient), SLS (single-leg stance)
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